Sonographic Findings in Necrotizing Fasciitis: Two Ends of the Spectrum

1Department of Emergency Medicine, San Francisco General Hospital, University of California, San Francisco, California USA;2Department of Radiology, University of California, San Francisco Medical Center, San Francisco, California USA;3Department of Emergency Medicine, San Francisco General Hospital, University of California, San Francisco, California USA

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Abstract

Necrotizing fasciitis is a rare but serious disease, and early diagnosis is essential to reducing its substantial morbidity and mortality. The 2 cases presented show that the key clinical and radiographic features of necrotizing fasciitis exist along a continuum of severity at initial presentation; thus, this diagnosis should not be prematurely ruled out in cases that do not show the dramatic features familiar to most clinicians. Although computed tomography and magnetic resonance imaging are considered the most effective imaging modalities, the cases described here illustrate how sonography should be recommended as an initial imaging test to make a rapid diagnosis and initiate therapy.